title: The increasing role of radiologists in thoracic diagnosis: more thoracic biopsies are performed percutaneously.
abstract: OBJECTIVE
  The rate of thoracic biopsies overall and by type of biopsy from 1998 to 2010 is not known. The aim of this study was to examine the utilization rate of various types of thoracic biopsies within the Medicare population.
  
  
  METHODS
  Source data was obtained from the CMS Physician/Supplier Procedure Summary Master Files from 1998 to 2010. Allowed primary claims submitted for percutaneous thoracic biopsy, bronchoscopic thoracic biopsy, and surgical thoracic biopsy were extracted. Annual volume and utilization rates were calculated and analyzed by biopsy type and provider type.
  
  
  RESULTS
  Total thoracic biopsy volume in 1998 was 176,125 and in 2010 was 167,911 (-4.7%). The utilization rate for all thoracic biopsies decreased from 5.47 per 1,000 in 1998 to 4.76 per 1,000 (-13.0%) in 2010. The percutaneous biopsy utilization rate increased 3.6% from 1998 to 2010, while the rate for surgical biopsy decreased by 20.9% and the rate of bronchoscopic biopsy decreased by 19.6% during the same time period. In 2010, radiologists performed 96.4% (58,679) of all percutaneous biopsies. Radiologists' thoracic biopsy market share increased from 26.2% (46,084 of 176,125) in 1998 to 35.0% (58,700 of 167,911) in 2010 (+33.6%).
  
  
  CONCLUSIONS
  The overall rate of thoracic biopsy decreased from 1998 to 2010, with fewer biopsies being performed surgically and bronchoscopically and more biopsies being performed percutaneously. Radiologists are responsible for an increasing role in thoracic diagnosis, as they have increased market share of thoracic biopsies. These findings may be the result of changing trends toward less invasive procedures, changing patterns of reimbursement, and increased availability of percutaneous biopsy.
authors.affiliation: Center for Research on Utilization of Imaging Services, Department of Radiology, Thomas Jefferson University Hospital and Jefferson Medical College, Philadelphia, Pennsylvania. Electronic address: richsharpejr@gmail.com.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Sharpe
authors.forename: David C
authors.initials: DC
authors.lastname: Levin
authors.forename: Laurence
authors.initials: L
authors.lastname: Parker
authors.forename: Vijay M
authors.initials: VM
authors.lastname: Rao
mesh_terms: D006801:Humans; D061705:Image-Guided Biopsy / Q000706:statistics & numerical data* / Q000639:trends; D006278:Medicare / Q000706:statistics & numerical data* / Q000639:trends; D015995:Prevalence; D013902:Radiography, Thoracic / Q000706:statistics & numerical data* / Q000639:trends; D011871:Radiology / Q000706:statistics & numerical data* / Q000639:trends; D013896:Thoracic Diseases / Q000453:epidemiology* / Q000473:pathology*; D014481:United States; D014600:Utilization Review
keywords: CT imaging; Medicare; health care economics; percutaneous biopsy; thoracic biopsy; thoracic radiology; utilization